Parish Registration

Thanks for taking a few moments to register your household's information with our parish's office. Please fill out the form as completely as possible and then scroll to the bottom and click submit.

Head of Household Information
Primary Adult in Household
Title
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Status
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Head of Household
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Maiden Name (if applicable)
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Home Address
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Primary Phone -- ext
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Secondary Phone --
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Email Address
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Date of Birth //
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Catholic:
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Occupation and Employer
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Talents or Expertise You Are Willing To Share
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VIRTUS //
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If you have completed the VIRTUS Training (the Diocese of Bridgeport's "Protecting God's Children" program), give us the date and place of training:
VIRTUS Location
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Sacraments You Have Received
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Details of Sacraments
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Date(s) and Church(es)/Address(es) of Sacraments:
Are there any special needs in this household?
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Is this information:
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Would you like to receive weekly offertory envelopes:
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Spouse/Other Adult Information
Title
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Status
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Name
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Maiden Name (if applicable)
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Address
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Primary Phone -- ext
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Secondary Phone -- ext
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E-mail
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Date of Birth //
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Catholic:
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Talents or Expertise You Are Willing To Share
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VIRTUS //
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If you have completed the VIRTUS Training (the Diocese of Bridgeport's "Protecting God's Children" program), give us the date and place of training:
VIRTUS Location
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Sacraments You Have Received
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Details of Sacraments
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Information for Other Adults in Household
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Other Members of the Household (Children)
Name
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Relationship
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Other Relationship
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Date of Birth //
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School Attending
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Current Grade Level:
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Phone --
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Catholic:
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Sacraments You Have Received
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Details of Sacraments
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VIRTUS //
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VIRTUS Location
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Information for Other Children in the Household
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